Straight answers
Frequently Asked Questions
These are the questions we hear every week across the kitchen table — answered the same way we'd answer them in person. Don't see yours? Call 208-350-9933 and ask a real human. That's kind of our whole thing.
Medicare basics
How Does Medicare Actually Work?
Who is eligible for Medicare?
Medicare is the federal health insurance program for people 65 and older. Certain younger people qualify too — those with qualifying disabilities and people with permanent kidney failure (End-Stage Renal Disease).
One thing worth knowing up front: Medicare helps with the cost of health care, but it does not cover all medical expenses — and it does not cover the cost of most long-term care. (That's a separate conversation; see our long-term care page.)
What's the difference between Medicare Advantage and a Medicare Supplement (Medigap)?
Medicare Advantage (Part C) is a private plan that replaces how you receive your Original Medicare benefits. It usually has a low or $0 premium, a network of doctors, and often includes drug coverage and extras like dental — you pay copays as you go.
A Medicare Supplement (Medigap) works alongside Original Medicare, filling in the deductibles and coinsurance. You can see any doctor in the country who accepts Medicare, but the monthly premium is higher and you buy a separate Part D drug plan.
Neither one is "better." It comes down to your doctors, your prescriptions, how you travel, and your budget — which is exactly what our 6-area comparison sorts out.
Are prescription drugs covered by Medicare?
Original Medicare (Parts A and B) covers very few outpatient prescriptions. Drug coverage comes through Medicare Part D — it's voluntary, and you pay a monthly premium for it.
You can get Part D as a stand-alone plan next to Original Medicare or a Medigap plan, or built into most Medicare Advantage plans. Good news for the 2026 plan year: your out-of-pocket drug costs are capped at $2,100 for the year.
What is Idaho's Medigap birthday rule?
Idaho has one of the most consumer-friendly Medigap rules in the country. Since March 2022, Medigap policyholders here get an annual window of roughly 63 days around their birthday to switch to another Medigap plan with equal or lesser benefits — without medical underwriting.
In plain English: no health questions can be used to deny you or jack up your rate during that window. It means Idahoans should re-shop their Supplement every year — and yes, we'll run that comparison for you for free.
Enrollment
When and How Do I Sign Up?
How do I apply for Medicare Parts A and B?
Many people are enrolled in Parts A and B automatically — typically if you're already receiving Social Security or Railroad Retirement Board benefits when you become eligible. If you're not, you apply through Social Security at ssa.gov, by phone, or at a local office.
Part B charges a monthly premium ($202.90 standard for the 2026 plan year), so some people who are still working choose to delay it. Whether that's smart depends on your employer coverage — timing mistakes here can be expensive. Not sure? Call us at 208-350-9933 before you decide.
When can I sign up for Medicare?
Your first chance is your Initial Enrollment Period — a 7-month window around your 65th birthday: the 3 months before your birthday month, your birthday month itself, and the 3 months after.
Sign up early in that window. Enrolling late in it can delay when your coverage actually starts, and missing it entirely can mean lifelong late penalties. If you're still working at 65 with employer coverage, different rules apply — our Turning 65 checklist walks through it step by step.
When is Medicare's Annual Enrollment Period (AEP)?
The Annual Enrollment Period runs October 15 through December 7 every year, with changes taking effect January 1. During AEP you can switch Medicare Advantage plans, move between Original Medicare and Medicare Advantage, and change Part D drug plans.
There's also a Medicare Advantage Open Enrollment Period from January 1 to March 31: if you're already on an Advantage plan, you get one switch — or you can return to Original Medicare. Our enrollment periods guide lays out every window on one page.
I'm under 65 — can I enroll in coverage through Your Health Idaho?
Yes. If you're under 65 and don't have coverage through an employer, Idaho residents shop ACA/Marketplace plans through Your Health Idaho — the state's official health insurance exchange. (Idaho runs its own exchange, so HealthCare.gov isn't the path here.)
Open enrollment happens each fall, and life events like losing job coverage, moving, or getting married can open a Special Enrollment Period any time of year. We can run your quote and handle the whole enrollment with you at no extra cost — start with our ACA page.
Costs & coverage
What Will It Cost — and What's Actually Covered?
How do I qualify for Extra Help with prescription drug costs?
If you have limited income and resources, you may qualify for Extra Help — a federal program that helps pay Part D premiums, deductibles, and copays. Qualification is based on your income and assets, and plenty of Idahoans who qualify never apply because they assume they won't.
It costs nothing to check. Call us at 208-350-9933 or email carrieanne@ptibidaho.com and we'll help you find out and get the application in.
Do subsidies really make Your Health Idaho plans affordable?
For most enrollees, yes. Advance Premium Tax Credits are based on your household income and size, and they lower your monthly premium — often dramatically. Many Your Health Idaho enrollees pay far less than sticker price, and some also qualify for reduced deductibles and copays.
The catch is estimating your income correctly, which is exactly the kind of thing we help with. Bring us your household numbers and we'll show you the real math for the 2026 plan year.
Does Medicare pay for long-term care?
Mostly, no — and this surprises a lot of people. Medicare covers short rehabilitative stays after a hospital admission, but not most long-term custodial care: extended nursing home stays, assisted living, or ongoing help at home.
That's what long-term care insurance is for — protecting your savings from care costs that can run into six figures. The best time to look at it is your 50s or early 60s, while premiums are lower and health qualifying is easier. Our honest LTC guide covers the whole picture.
Do I really need life insurance?
If anyone depends on your income — a spouse, kids, a business partner, even a co-signed mortgage — some amount of life insurance is usually wise. Term life covers a set number of years at the lowest cost; permanent policies last your lifetime and can build cash value; final expense policies are smaller plans that cover funeral and end-of-life costs.
We compare options from multiple carriers, and we'll tell you honestly if you need less than you think. Start with our life insurance page.
Working with us
What's It Like to Work With Personal Touch?
Does working with an agent cost me extra?
No. Our help is free to you. Agents are paid by the insurance carriers, and your premium is exactly the same whether you enroll through us, directly with the carrier, or online by yourself.
The difference is what you get for the same price: a human who compares multiple companies, explains the fine print, and picks up the phone when something goes sideways with a claim next year.
Do you only sell one company's plans?
No — we're an independent agency, which means we don't work for any single insurance company. We compare plans from nine carriers: Blue Cross of Idaho, Regence Blue Shield of Idaho, SelectHealth, PacificSource, Molina, Aetna, Mutual of Omaha, Physicians Mutual, and Manhattan Life.
Our only job is finding the plan that fits you — not hitting a quota for one company. Learn more about how we work on our About page.
What should I bring to my appointment?
Three things do most of the work:
- A list of your doctors and preferred hospitals
- A list of your prescriptions, with dosages
- A rough idea of your monthly budget
If you have current coverage, bring that card or policy so we can compare against what you already have. Medicare clients should also bring their red, white, and blue Medicare card. That's it — Patricia will make sure you're set before your meeting.
Do you serve my county?
Yes — we're licensed throughout Idaho and work with clients in every county by phone, from Bonner to Bear Lake. Most of our clients are in Ada and Canyon counties, and Boise County (Idaho City, Horseshoe Bend, Crouch) is the one county where we also make in-person visits.
Wherever you are in Idaho, call 208-350-9933 — the whole comparison works great over the phone.
We do not offer every plan available in your area. Currently we represent 5 organizations which offer 300 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
Still Have a Question? Good — We Like Those.
No question is too small, and asking costs nothing. Call and get a plain-English answer from a real Idaho agent — no pressure, no obligation, ever.